Re: [Histonet] Re: Fixatives

From:"Katri Tuomala"

I have always read with respect Dr. Richmond's opinions, but here I have to 

Surely the bottle, that the specimen comes in, is labelled with what ever 
the fixative is, along with the pertinent patient information. It should be 
just as simple to say " specimen received in formalin (Bouins, Zenkers 
etc.)". There is no need and it is not advisable to smell it.

It is an interesting mindset among many, not all, pathologist to insist in 
processing all tissues the same day (TAT!) ending up with inadequately fixed 
and consequently poorly processed tissue, which we technologist then have to 
struggle to produce well stained, wrinkle free, representative sections. As 
an immuno tech I can testify for even bigger problems in producing reliable 
results with immunohistochemical procedures.

For purposes of immunostaining, it is important to know the time of fixation 
in formalin, adequate or not (24 hours is considered adequate, not 4 or even 
8), so that we know what we are faced with and sometimes method can be 
adjusted to fit the fixation time. I would prefer doing immuno stains on a 
specimen, that is "overfixed" in formalin rather than underfixed.

If I ever ended up with breast cancer, I would make sure, that at least one 
tumor section got fixed 24 hours.

This is my Tuesday Rant!

Katri Tuomala
Hamilton, Ontario, Canada

----- Original Message ----- 
Sent: Tuesday, May 23, 2006 4:22 AM
Subject: [Histonet] Re: Fixatives

> Patti Loykasek at PhenoPath Laboratories notes >>We are a reference lab 
> and
> receive specimens from all over the USA. One of my "pet peeves" is that it 
> is
> rare to see in the report exactly what type of fixative the specimen was
> received in or subsequently processed in. I know we have no standard form 
> of
> reporting, but it just seems like best practice to me to include this 
> information on
> the report. One of my favorites is "...received in fixative..." - not very
> helpful.<<
> That's exactly the phrase I use in my gross descriptions, and for a very 
> good
> reason. I'm not about to stick my nose into every specimen bottle to 
> verify
> that it contains formalin and not alcohol, water, or pine-scented floor
> disinfectant (used at one hospital I know as a "fixative" for placentas). 
> I'm willing
> to smell-test a very occasional container where I'm suspicious that the 
> wrong
> fixative has been used, but not every time!
> Time of fixation is the dead horse in the middle of the living room 
> floor -
> nobody wants to hear that the HER2 immunostain for breast cancer requires
> overnight fixation, for example.
> Bob Richmond
> Gastonia NC
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